Laserfiche WebLink
LIQUID WASTE PERMIT <br /> SAN'JOAQUIN COUNTY PUJ3LIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION <br /> 304 E.WEBER AVE 3M'FLOOR,RTOCKTOV,CA 95202(209)8611.3420 <br /> /,yJ NON. F INDABLE PERMIT EXPIRES I YEAR FROM DATE ISSUED9 <br /> JOB AUDRE.45,/�i�•'� CV/' 1617a "1/ _, APIC__. D���,•,['7'L,��Lr PARCELSfZF.:- _�.J <br /> CITYIZIP...._G:C� �,� �•'�/J/J/!9�.�'zy2 BUILDING PERMIT,# <br /> j////y _..._____.. <br /> OWNER NAME_ /l..�rFtt1/ `"�,`�I AUURESS 13'`�}��` `��.�y C ��• - <br /> CITY/ZIP,CdLL�Lrf�.__..�L.L147 PRONE <br /> CONTRACTOR .. .___— ADDRESS <br /> CITV12..LP _ PHONE NCMBER <br /> C.EOCRAPHICAL INFORMATION: COORDINATE$:X_ Y_ TOWNSHIP._ RANGE• .,SECTION <br /> TYPE OF SEPTIC WORK: INSTALLATION WILL SERVE: NUMBER OF LIVING UNITS: <br /> ❑ NEW NSTALLATION Q RESIDENCE NLTIBEROFBEDROOMS: <br /> ❑d REPAIWADDITION Q COMMERCIAL NUM1IBEROFEMPLOYEES: <br /> `C DESTRUCTION D OTHER <br /> ❑ ENGINEEREMALTF.RNATIVF. <br /> CHARACTER OF SOIL TO DEPTH OF 3':_ PITISUMP SOIL CHAR-.CTER:_ WATERTABLE DEPTH: <br /> ❑ FERC TESTIS) IIOW MANY _._.. APPLICATION# <br /> ❑ SEPTICTANK TYPEIMFG CAPACITY XOFCOMPARTMENTS <br /> ❑ GREASETRAP TYPFJMFG _ CAPACITY XOFCOMPARTMENTS _ <br /> ❑ PKGTX PLANT DISTANCE TO NEAREST! WELL_ FOUNDATION PROPERTYLINE-__� <br /> ❑ LIFTSTATION SIZE_ rYPFOFPUMP SAND OIL SEPARATOR(ENCLOSED SYSTEM) _ A <br /> ❑ LEACII LINE 0 OF LINES: LENGTH OF LINES:__ aITANce To NEAREsr: WFUl FOUNDATION PROPERTY UNE V <br /> INFLITRATOR CHAMBERS: <br /> ' ❑ FILTER BED WIDTH LENGTH DEPTH­ DufAnce ToneARLCf: WELL FOUNDATION PRCMERTY LINE <br /> ❑ MOUNDED WIDT'N LENGTH DEPTH___ DR7ANCETONG L%T: WELL FOUNDATION PROPERTY UNE <br /> SUMPS WIDTHLENT;TH DEPTH OWr-CKTONE WT: WF.IJ. FOUNDATION PROPERTY LINE ' <br /> ❑ DISPOSAL PONDS WIDTH LENGTII__ DEPTH DLSTARCETONEAREQ: WELL FOUNDATION PROPERTY LINE <br /> ❑ SEEPAGE PITS k DIAMETER DEPTH DFGNCETONEARFST: WELL FOUNDATION PROPERTY LINE---- <br /> I <br /> INE__1 HERESY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THE WORK WILL BE DONE.IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES,STATE LAWS <br /> AND RULES AND REGULATIONS O)'SAN JOAQUIN COUNTY• <br /> MINIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS—PLEASE CALL(209)46BN3423 <br /> SIGNED: —21i—��^'� -- _TITLE. <br /> : <br /> % <br /> : <br /> 1 I I ! <br /> : <br /> : <br /> 1 <br /> ; <br /> —.1.. <br /> : <br /> t <br /> l� <br /> �. <br /> , <br /> : <br /> : <br /> r.. .. r. .}.. .�_...E.. i. ... y:f,9Ly�' ter'. UB�IC AlHSERVCES _.. <br /> ft p._..�.�--.y__ .... `c NVIHCF1hiENjll4tjlEAIRH4(Iyf4lllh <br /> ' DEPARTMENT IIMFO ILY <br /> -ZkRE•A�`-WPLOYEE IDN U DLSI'RI _ _,_..L CATION <br /> APPLICATIONAKEP;EIA HV '`�� ,,,._.DATE' LS T9 <br /> INSPECTED BY: <br /> DAIF._g4ff'G e�4 PERV.ITFINAL11/YESDATC: INSPECTOR. <br /> COMMENTS CN I.N/,(5 Ia�/`D T♦� P/�"i ..__.._. — <br /> Pb CJDE SC WFO I AMOLNT CIIEC•K�•-SN KEC'CIVEO DATE PERMR.N'ERVICE REQUESTY INVOICED SEPTMIDM <br /> REMIT fLU RY <br /> -751 <br /> I <br /> REVISED RIS•4I - - <br />